Author - Dr.Kaushal Malhan

When must a person undergo knee-replacement surgery? A doctor answers

When it involves the physique, most individuals take it without any consideration and intentionally push their physician appointments, whereas figuring out absolutely effectively they want the check-up. When this occurs, an already-existing well being difficulty could irritate, inflicting them extra inconvenience. Among different issues, bone well being turns into extraordinarily very important after a sure age, and medical doctors advise their sufferers to get themselves checked.

According to a research printed within the Journal of Bone and Joint Surgery, a overwhelming majority of sufferers — who would profit from knee alternative — are taking too lengthy to have a surgical procedure, to the detriment of their mobility and total well being, factors out Dr Kaushal Malhan, director orthopedic surgical procedure, Fortis Hospital, Mulund. “The study also showed delayed knee surgery has negative effects on post-operative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems; this proved to be even more detrimental,” he tells indianexpress.com.

Total Knee Replacement

Total Knee Replacement or TKR is an operation for the tip stage extreme arthritis of the knees. “It has the power to right not solely the worn out surfaces, but additionally the mechanics, and therefore offering a secure well-aligned joint. In spite of developments within the process, some individuals maintain on to outdated notions of its dangers and outcomes, and delay it for so long as they will, which may probably influence the post-operation operate.

“The correct timing of surgery is essential to optimise results of the operation. So, the question that should be asked is: ‘Is it safe to delay knee replacement surgery, and for how long should one wait before committing to it?’”

What is knee arthritis?

Dr Malhan explains that it’s a progressive dysfunction. The floor of the joint retains getting abraded and bone loss happens. This leads to deformity. There is irregular stress on the ligaments, too, which can progressively stretch out and result in instability of the joint.

“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.

So what’s the preferrred time, and what ought to a affected person have in mind?

The physician explains that whereas it could range from person-to-person, some pointers should be thought-about:

1. It must be carried out when the knee issues considerably restrict features.
2. Before main deformity, bone loss and muscle atrophy units in.
3. Earlier in sufferers with one good knee, in order that it doesn’t get affected due to the dangerous one.
4. Value of this surgical procedure is larger when total mobility and energy is passable. No level in ready until one is simply too outdated to bear the surgical procedure.
5. Do it earlier than different age-related illnesses forestall us from committing to the operation.
6. Earlier surgical procedure in sufferers with deformity and joint instability.
7. Early if any situation predisposes to quicker put on and tear of the joint.
8. People with progressive medical situations that are below management could think about surgical procedure earlier than it’s too late.

Reference: https://livenewsindia.net/health/when-must-a-person-undergo-knee-replacement-surgery-a-doctor-answers/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

When must a person undergo knee-replacement surgery? A doctor answers

Relating to the physique, most individuals take it as a right and intentionally push their physician appointments, whereas understanding totally properly they want the check-up. When this occurs, an already-existing well being subject could worsen, inflicting them extra inconvenience. Amongst different issues, bone well being turns into extraordinarily important after a sure age, and docs advise their sufferers to get themselves checked.

Based on a examine revealed within the Journal of Bone and Joint Surgical procedure, a overwhelming majority of sufferers — who would profit from knee alternative — are taking too lengthy to have a surgical procedure, to the detriment of their mobility and total well being, factors out Dr Kaushal Malhan, director orthopedic surgical procedure, Fortis Hospital, Mulund. “The examine additionally confirmed delayed knee surgical procedure has unfavourable results on post-operative restoration. Throughout the COVID-19 pandemic, many sufferers delayed addressing their joint and bone issues; this proved to be much more detrimental,” he tells indianexpress.com.

Complete Knee Substitute

Complete Knee Substitute or TKR is an operation for the tip stage extreme arthritis of the knees. “It has the power to appropriate not solely the worn out surfaces, but additionally the mechanics, and therefore offering a secure well-aligned joint. Despite developments within the process, some folks maintain on to outdated notions of its dangers and outcomes, and delay it for so long as they will, which might doubtlessly affect the post-operation perform.

“The right timing of surgical procedure is important to optimise outcomes of the operation. So, the query that needs to be requested is: ‘Is it protected to delay knee alternative surgical procedure, and for a way lengthy ought to one wait earlier than committing to it?’”

What’s knee arthritis?

Dr Malhan explains that it’s a progressive dysfunction. The floor of the joint retains getting abraded and bone loss happens. This ends in deformity. There’s irregular stress on the ligaments, too, which can regularly stretch out and result in instability of the joint.

“An excellent main TKR with wholesome bone inventory, secure ligaments and passable joint alignment guarantees long-term success. Extreme delay could compromise the process affecting longevity of implants. There additionally could also be dangers in getting the surgical procedure achieved too early,” he warns.

So what’s the ideally suited time, and what ought to a affected person consider?

The physician explains that whereas it could range from person-to-person, some pointers must be thought-about:

1. It must be achieved when the knee issues considerably restrict features.
2. Earlier than main deformity, bone loss and muscle atrophy units in.
3. Earlier in sufferers with one good knee, in order that it doesn’t get affected due to the unhealthy one.
4. Worth of this surgical procedure is bigger when total mobility and power is passable. No level in ready until one is just too outdated to bear the surgical procedure.
5. Do it earlier than different age-related illnesses stop us from committing to the operation.
6. Earlier surgical procedure in sufferers with deformity and joint instability.
7. Early if any situation predisposes to sooner put on and tear of the joint.
8. Folks with progressive medical circumstances that are underneath management could take into account surgical procedure earlier than it’s too late.

Reference: https://www.thelatestbulletin.com/when-must-a-person-undergo-knee-replacement-surgery-a-doctor-answers/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

When must a person undergo knee-replacement surgery? A doctor answers

In terms of the physique, most individuals take it as a right and intentionally push their physician appointments, whereas figuring out absolutely properly they want the check-up. When this occurs, an already-existing well being concern might irritate, inflicting them extra inconvenience. Amongst different issues, bone well being turns into extraordinarily important after a sure age, and docs advise their sufferers to get themselves checked.

In keeping with a examine printed within the Journal of Bone and Joint Surgical procedure, a overwhelming majority of sufferers — who would profit from knee substitute — are taking too lengthy to have a surgical procedure, to the detriment of their mobility and general well being, factors out Dr Kaushal Malhan, director orthopedic surgical procedure, Fortis Hospital, Mulund. “The examine additionally confirmed delayed knee surgical procedure has destructive results on post-operative restoration. Through the COVID-19 pandemic, many sufferers delayed addressing their joint and bone issues; this proved to be much more detrimental,” he tells indianexpress.com.

Whole Knee Substitute

Whole Knee Substitute or TKR is an operation for the top stage extreme arthritis of the knees. “It has the flexibility to appropriate not solely the worn out surfaces, but in addition the mechanics, and therefore offering a secure well-aligned joint. Despite developments within the process, some individuals maintain on to outdated notions of its dangers and outcomes, and delay it for so long as they will, which might probably affect the post-operation perform.

“The proper timing of surgical procedure is crucial to optimise outcomes of the operation. So, the query that must be requested is: ‘Is it protected to delay knee substitute surgical procedure, and for the way lengthy ought to one wait earlier than committing to it?’”

What’s knee arthritis?

Dr Malhan explains that it’s a progressive dysfunction. The floor of the joint retains getting abraded and bone loss happens. This leads to deformity. There may be irregular stress on the ligaments, too, which can regularly stretch out and result in instability of the joint.

“A very good main TKR with wholesome bone inventory, secure ligaments and passable joint alignment guarantees long-term success. Extreme delay might compromise the process affecting longevity of implants. There additionally could also be dangers in getting the surgical procedure accomplished too early,” he warns.

So what’s the splendid time, and what ought to a affected person remember?

The physician explains that whereas it could differ from person-to-person, some pointers should be thought-about:

1. It must be accomplished when the knee issues considerably restrict features.
2. Earlier than main deformity, bone loss and muscle atrophy units in.
3. Earlier in sufferers with one good knee, in order that it doesn’t get affected due to the dangerous one.
4. Worth of this surgical procedure is bigger when general mobility and power is passable. No level in ready until one is simply too outdated to endure the surgical procedure.
5. Do it earlier than different age-related illnesses stop us from committing to the operation.
6. Earlier surgical procedure in sufferers with deformity and joint instability.
7. Early if any situation predisposes to quicker put on and tear of the joint.
8. Individuals with progressive medical situations that are underneath management might think about surgical procedure earlier than it’s too late.

Read more...

When must a person undergo knee-replacement surgical procedure? A doctor answers

When it involves the physique, most individuals take it with no consideration and intentionally push their doctor appointments, whereas realizing absolutely effectively they want the check-up. When this occurs, an already-existing well being situation might irritate, inflicting them extra inconvenience. Among different issues, bone well being turns into extraordinarily very important after a sure age, and medical doctors advise their sufferers to get themselves checked.

According to a examine printed within the Journal of Bone and Joint Surgery, a overwhelming majority of sufferers — who would profit from knee substitute — are taking too lengthy to have a surgical procedure, to the detriment of their mobility and general well being, factors out Dr Kaushal Malhan, director orthopedic surgical procedure, Fortis Hospital, Mulund. “The study also showed delayed knee surgery has negative effects on post-operative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems; this proved to be even more detrimental,” he tells indianexpress.com.

Total Knee Replacement

Total Knee Replacement or TKR is an operation for the top stage extreme arthritis of the knees. “It has the power to appropriate not solely the worn out surfaces, but additionally the mechanics, and therefore offering a steady well-aligned joint. In spite of developments within the process, some folks maintain on to outdated notions of its dangers and outcomes, and delay it for so long as they will, which might probably influence the post-operation perform.

“The correct timing of surgery is essential to optimise results of the operation. So, the question that should be asked is: ‘Is it safe to delay knee replacement surgery, and for how long should one wait before committing to it?’”

What is knee arthritis?

Dr Malhan explains that it’s a progressive dysfunction. The floor of the joint retains getting abraded and bone loss happens. This ends in deformity. There is irregular stress on the ligaments, too, which can regularly stretch out and result in instability of the joint.

“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.

So what’s the preferrred time, and what ought to a affected person bear in mind?

The doctor explains that whereas it could range from person-to-person, some pointers should be thought of:

1. It must be achieved when the knee issues considerably restrict features.
2. Before main deformity, bone loss and muscle atrophy units in.
3. Earlier in sufferers with one good knee, in order that it doesn’t get affected due to the unhealthy one.
4. Value of this surgical procedure is bigger when general mobility and power is passable. No level in ready until one is just too previous to undergo the surgical procedure.
5. Do it earlier than different age-related illnesses stop us from committing to the operation.
6. Earlier surgical procedure in sufferers with deformity and joint instability.
7. Early if any situation predisposes to quicker put on and tear of the joint.
8. People with progressive medical circumstances that are below management might contemplate surgical procedure earlier than it’s too late.

Reference: https://newspolo.com/when-must-a-person-undergo-knee-replacement-surgery-a-doctor-answers/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

When must a person undergo knee-replacement surgery? A doctor answers

Total Knee Replacement or TKR is an operation for the end stage severe arthritis of the knees, says the doctor

When it comes to the body, most people take it for granted and deliberately push their doctor appointments, while knowing fully well they need the check-up. When this happens, an already-existing health issue may aggravate, causing them more inconvenience. Among other things, bone health becomes extremely vital after a certain age, and doctors advise their patients to get themselves checked.

According to a study published in the Journal of Bone and Joint Surgery, a vast majority of patients — who would benefit from knee replacement — are taking too long to have a surgery, to the detriment of their mobility and overall health, points out Dr Kaushal Malhan, director orthopedic surgery, Fortis Hospital, Mulund. “The study also showed delayed knee surgery has negative effects on post-operative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems; this proved to be even more detrimental,” he tells indianexpress.com.

Total Knee Replacement

Total Knee Replacement or TKR is an operation for the end stage severe arthritis of the knees. “It has the ability to correct not only the worn out surfaces, but also the mechanics, and hence providing a stable well-aligned joint. In spite of advancements in the procedure, some people hold on to outdated notions of its risks and outcomes, and delay it for as long as they can, which can potentially impact the post-operation function.

“The correct timing of surgery is essential to optimise results of the operation. So, the question that should be asked is: ‘Is it safe to delay knee replacement surgery, and for how long should one wait before committing to it?’”

What is knee arthritis?

Dr Malhan explains that it is a progressive disorder. The surface of the joint keeps getting abraded and bone loss occurs. This results in deformity. There is abnormal stress on the ligaments, too, which will gradually stretch out and lead to instability of the joint.

“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.

So what is the ideal time, and what should a patient keep in mind?

The doctor explains that while it may vary from person-to-person, some pointers ought to be considered:

1. It needs to be done when the knee problems significantly limit functions.
2. Before major deformity, bone loss and muscle atrophy sets in.
3. Earlier in patients with one good knee, so that it does not get affected because of the bad one.
4. Value of this surgery is greater when overall mobility and strength is satisfactory. No point in waiting till one is too old to undergo the surgery.
5. Do it before other age-related ailments prevent us from committing to the operation.
6. Earlier surgery in patients with deformity and joint instability.
7. Early if any condition predisposes to faster wear and tear of the joint.
8. People with progressive medical conditions which are under control may consider surgery before it is too late.

Reference: https://newsheadlines.co.in/when-must-a-person-undergo-knee-replacement-surgical-procedure-a-doctor-answers/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

When must a person undergo knee-replacement surgery? A doctor answers

Total Knee Replacement or TKR is an operation for the end-stage severe arthritis of the knees, says the doctor

When it comes to the body, most people take it for granted and deliberately push their doctor appointments, while knowing fully well they need the check-up. When this happens, an already-existing health issue may aggravate, causing them more inconvenience. Among other things, bone health becomes extremely vital after a certain age, and doctors advise their patients to get themselves checked.

According to a study published in the Journal of Bone and Joint Surgery, a vast majority of patients — who would benefit from knee replacement — are taking too long to have a surgery, to the detriment of their mobility and overall health, points out Dr Kaushal Malhan, director orthopedic surgery, Fortis Hospital, Mulund. “The study also showed delayed knee surgery has negative effects on post-operative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems; this proved to be even more detrimental,” he tells indianexpress.com.

Total Knee Replacement

Total Knee Replacement or TKR is an operation for the end stage severe arthritis of the knees. “It has the ability to correct not only the worn out surfaces, but also the mechanics, and hence providing a stable well-aligned joint. In spite of advancements in the procedure, some people hold on to outdated notions of its risks and outcomes, and delay it for as long as they can, which can potentially impact the post-operation function.

“The correct timing of surgery is essential to optimise results of the operation. So, the question that should be asked is: ‘Is it safe to delay knee replacement surgery, and for how long should one wait before committing to it?’”

What is knee arthritis?

Dr Malhan explains that it is a progressive disorder. The surface of the joint keeps getting abraded and bone loss occurs. This results in deformity. There is abnormal stress on the ligaments, too, which will gradually stretch out and lead to instability of the joint.

“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.

What is knee arthritis?

Dr Malhan explains that it is a progressive disorder. The surface of the joint keeps getting abraded and bone loss occurs. This results in deformity. There is abnormal stress on the ligaments, too, which will gradually stretch out and lead to instability of the joint.

“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.

So what is the ideal time, and what should a patient keep in mind?

The doctor explains that while it may vary from person-to-person, some pointers ought to be considered:

1. It needs to be done when the knee problems significantly limit functions.
2. Before major deformity, bone loss and muscle atrophy sets in.
3. Earlier in patients with one good knee, so that it does not get affected because of the bad one.
4. Value of this surgery is greater when overall mobility and strength is satisfactory. No point in waiting till one is too old to undergo the surgery.
5. Do it before other age-related ailments prevent us from committing to the operation.
6. Earlier surgery in patients with deformity and joint instability.
7. Early if any condition predisposes to faster wear and tear of the joint.
8. People with progressive medical conditions which are under control may consider surgery before it is too late.

Reference: https://indianexpress.com/article/lifestyle/health/when-must-a-person-undergo-knee-replacement-surgery-a-doctor-answers-7183142/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

Advanced Trauma Life Support: How can lay people save lives of accident victims?

A total of 151,113 people were killed in 480,652 road accidents across India in 2019, an average of 414 a day, or 17 an hour, according to a 2019 report published by the Government’s Transport Research Wing.  India has the maximum number of deaths due to road accidents highlights the report. Apparently, Maharashtra ranks on the 6th position with 32,295 accidents, but saw the second-highest number of fatalities (12,788).

India continued to have the most road fatalities in the world, followed by China, a distant second at 63,093 deaths in 2,12,846 road accidents, a report revealed. The United States of America (USA) reported the most road accidents at 2,211,439, and witnessed 37,461 deaths in 2019. According to the report, speeding was the leading cause of deaths, while, in terms of vehicles, two-wheelers were involved in most road fatalities.

Among metro cities, Mumbai ranked 9th with 447 people being killed in road accidents in 2019. The World Report on Road Traffic Injury Prevention, indicates that road traffic accidents are a major killer accounting for half a million deaths and 15 million disability adjusted life years lost. It has been seen that victims of major road accidents in India have a much higher risk of death as compared to developed nations.

SIGNIFICANCE OF THE GOLDEN HOUR: Accident victims deteriorate quickly after injury, delay in treatment has shown to significantly increase mortality. The first 60 minutes, also called the ‘Golden Hour’ is crucial and affects chances of survival for trauma victims.  The golden hour rule can be summarized by ‘3R rule of getting the right patient to the right place in right time’. The role of good and swift emergency medical transport with trained paramedics or medics cannot be over emphasized. This is because appropriate trauma-centers may not always be nearby and the medical team can provide trauma care at the scene and on-route to hospital.

HOW CAN THE COMMUNITY CONTRIBUTE IN SAVING LIVES? Emergency medical transport may not be always available on time and therefore the community at large along with Police, Fire Fighters etc., should be trained to provide on-site first aid. This is based on the principles of ATLS-Advanced Trauma Life Support. The primary role is to cause no harm and call for help. Emergency on-site care by lay public should follow the following protocol:

A-Airway maintenance with cervical spine protection – Check if there is any removable obstruction to breathing. Prevent aspiration by correct positioning. Avoid moving the neck and stabilize it in place using some supporting object on either side. Do not forcibly remove a helmet and cause unnecessary neck movement

B-Breathing and ventilation – Give oxygen if available and mouth to mouth resuscitation for victims who are not breathing in spite of a clear airway

C-Circulation with hemorrhage control – provide external cardiac massage in pulseless patients. Stop bleeding by applying direct pressure on bleeding area, apply splint to broken limbs

D-Disability – Gross assessment of state of consciousness, power and sensation in the limbs will be useful later to decide about progress and clinical worsening

E-Exposure – Cover the patient and protect them from cold and transfer safely without unnecessary movement

All attempts should be made to quickly transfer patient to an appropriate facility with prior intimation to the medical center. It would also be helpful to have nearby emergency aid numbers handy.

Reference: https://wellbeinginsider.com/advanced-trauma-life-support-how-can-lay-people-save-lives-of-accident-victims/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

Advanced Trauma Life Support: How can lay people save lives of accident victims?

A total of 151,113 people were killed in 480,652 road accidents across India in 2019, an average of 414 a day, or 17 an hour, according to a 2019 report published by the Government’s Transport Research Wing.  India has the maximum number of deaths due to road accidents highlights the report. Apparently, Maharashtra ranks on the 6th position with 32,295 accidents, but saw the second-highest number of fatalities (12,788).

India continued to have the most road fatalities in the world, followed by China, a distant second at 63,093 deaths in 2,12,846 road accidents, a report revealed. The United States of America (USA) reported the most road accidents at 2,211,439, and witnessed 37,461 deaths in 2019. According to the report, speeding was the leading cause of deaths, while, in terms of vehicles, two-wheelers were involved in most road fatalities.

Among metro cities, Mumbai ranked 9th with 447 people being killed in road accidents in 2019. The World Report on Road Traffic Injury Prevention, indicates that road traffic accidents are a major killer accounting for half a million deaths and 15 million disability adjusted life years lost. It has been seen that victims of major road accidents in India have a much higher risk of death as compared to developed nations.

SIGNIFICANCE OF THE GOLDEN HOUR: Accident victims deteriorate quickly after injury, delay in treatment has shown to significantly increase mortality. The first 60 minutes, also called the ‘Golden Hour’ is crucial and affects chances of survival for trauma victims.  The golden hour rule can be summarized by ‘3R rule of getting the right patient to the right place in right time’. The role of good and swift emergency medical transport with trained paramedics or medics cannot be over emphasized. This is because appropriate trauma-centers may not always be nearby and the medical team can provide trauma care at the scene and on-route to hospital.

HOW CAN THE COMMUNITY CONTRIBUTE IN SAVING LIVES? Emergency medical transport may not be always available on time and therefore the community at large along with Police, Fire Fighters etc., should be trained to provide on-site first aid. This is based on the principles of ATLS-Advanced Trauma Life Support. The primary role is to cause no harm and call for help. Emergency on-site care by lay public should follow the following protocol:

A-Airway maintenance with cervical spine protection – Check if there is any removable obstruction to breathing. Prevent aspiration by correct positioning. Avoid moving the neck and stabilize it in place using some supporting object on either side. Do not forcibly remove a helmet and cause unnecessary neck movement

B-Breathing and ventilation – Give oxygen if available and mouth to mouth resuscitation for victims who are not breathing in spite of a clear airway

C-Circulation with hemorrhage control – provide external cardiac massage in pulseless patients. Stop bleeding by applying direct pressure on bleeding area, apply splint to broken limbs

D-Disability – Gross assessment of state of consciousness, power and sensation in the limbs will be useful later to decide about progress and clinical worsening

E-Exposure – Cover the patient and protect them from cold and transfer safely without unnecessary movement

All attempts should be made to quickly transfer patient to an appropriate facility with prior intimation to the medical center. It would also be helpful to have nearby emergency aid numbers handy.

Reference: https://www.biotechasianews.com/advanced-trauma-life-support-how-can-lay-people-save-lives-of-accident-victims/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

Advanced Trauma Life Support: How can lay people save lives of accident victims?

A total of 151,113 people were killed in 480,652 road accidents across India in 2019, an average of 414 a day, or 17 an hour, according to a 2019 report published by the Government’s Transport Research Wing.  India has the maximum number of deaths due to road accidents highlights the report. Apparently, Maharashtra ranks on the 6th position with 32,295 accidents, but saw the second-highest number of fatalities (12,788).

India continued to have the most road fatalities in the world, followed by China, a distant second at 63,093 deaths in 2,12,846 road accidents, a report revealed. The United States of America (USA) reported the most road accidents at 2,211,439, and witnessed 37,461 deaths in 2019. According to the report, speeding was the leading cause of deaths, while, in terms of vehicles, two-wheelers were involved in most road fatalities.

Among metro cities, Mumbai ranked 9th with 447 people being killed in road accidents in 2019. The World Report on Road Traffic Injury Prevention, indicates that road traffic accidents are a major killer accounting for half a million deaths and 15 million disability adjusted life years lost. It has been seen that victims of major road accidents in India have a much higher risk of death as compared to developed nations.

SIGNIFICANCE OF THE GOLDEN HOUR: Accident victims deteriorate quickly after injury, delay in treatment has shown to significantly increase mortality. The first 60 minutes, also called the ‘Golden Hour’ is crucial and affects chances of survival for trauma victims.  The golden hour rule can be summarized by ‘3R rule of getting the right patient to the right place in right time’. The role of good and swift emergency medical transport with trained paramedics or medics cannot be over emphasized. This is because appropriate trauma-centers may not always be nearby and the medical team can provide trauma care at the scene and on-route to hospital.

HOW CAN THE COMMUNITY CONTRIBUTE IN SAVING LIVES? Emergency medical transport may not be always available on time and therefore the community at large along with Police, Fire Fighters etc., should be trained to provide on-site first aid. This is based on the principles of ATLS-Advanced Trauma Life Support. The primary role is to cause no harm and call for help. Emergency on-site care by lay public should follow the following protocol:

A-Airway maintenance with cervical spine protection – Check if there is any removable obstruction to breathing. Prevent aspiration by correct positioning. Avoid moving the neck and stabilize it in place using some supporting object on either side. Do not forcibly remove a helmet and cause unnecessary neck movement

B-Breathing and ventilation – Give oxygen if available and mouth to mouth resuscitation for victims who are not breathing in spite of a clear airway

C-Circulation with hemorrhage control – provide external cardiac massage in pulseless patients. Stop bleeding by applying direct pressure on bleeding area, apply splint to broken limbs

D-Disability – Gross assessment of state of consciousness, power and sensation in the limbs will be useful later to decide about progress and clinical worsening

E-Exposure – Cover the patient and protect them from cold and transfer safely without unnecessary movement

All attempts should be made to quickly transfer patient to an appropriate facility with prior intimation to the medical center. It would also be helpful to have nearby emergency aid numbers handy.

Reference: https://swasthsamachar.com/2021/02/08/advanced-trauma-life-support-how-can-lay-people-save-lives-of-accident-victims/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

Read more...

Advanced Trauma Life Support: How can lay people save lives of accident victims?

A total of 151,113 people were killed in 480,652 road accidents across India in 2019, an average of 414 a day, or 17 an hour, according to a 2019 report published by the Government’s Transport Research Wing.  India has the maximum number of deaths due to road accidents highlights the report. Apparently, Maharashtra ranks on the 6th position with 32,295 accidents, but saw the second-highest number of fatalities (12,788).

India continued to have the most road fatalities in the world, followed by China, a distant second at 63,093 deaths in 2,12,846 road accidents, a report revealed. The United States of America (USA) reported the most road accidents at 2,211,439, and witnessed 37,461 deaths in 2019. According to the report, speeding was the leading cause of deaths, while, in terms of vehicles, two-wheelers were involved in most road fatalities.

Among metro cities, Mumbai ranked 9th with 447 people being killed in road accidents in 2019. The World Report on Road Traffic Injury Prevention, indicates that road traffic accidents are a major killer accounting for half a million deaths and 15 million disability adjusted life years lost. It has been seen that victims of major road accidents in India have a much higher risk of death as compared to developed nations.

SIGNIFICANCE OF THE GOLDEN HOUR: Accident victims deteriorate quickly after injury, delay in treatment has shown to significantly increase mortality. The first 60 minutes, also called the ‘Golden Hour’ is crucial and affects chances of survival for trauma victims.  The golden hour rule can be summarized by ‘3R rule of getting the right patient to the right place in right time’. The role of good and swift emergency medical transport with trained paramedics or medics cannot be over emphasized. This is because appropriate trauma-centers may not always be nearby and the medical team can provide trauma care at the scene and on-route to hospital.

HOW CAN THE COMMUNITY CONTRIBUTE IN SAVING LIVES? Emergency medical transport may not be always available on time and therefore the community at large along with Police, Fire Fighters etc., should be trained to provide on-site first aid. This is based on the principles of ATLS-Advanced Trauma Life Support. The primary role is to cause no harm and call for help. Emergency on-site care by lay public should follow the following protocol:

A-Airway maintenance with cervical spine protection – Check if there is any removable obstruction to breathing. Prevent aspiration by correct positioning. Avoid moving the neck and stabilize it in place using some supporting object on either side. Do not forcibly remove a helmet and cause unnecessary neck movement

B-Breathing and ventilation – Give oxygen if available and mouth to mouth resuscitation for victims who are not breathing in spite of a clear airway

C-Circulation with hemorrhage control – provide external cardiac massage in pulseless patients. Stop bleeding by applying direct pressure on bleeding area, apply splint to broken limbs

D-Disability – Gross assessment of state of consciousness, power and sensation in the limbs will be useful later to decide about progress and clinical worsening

E-Exposure – Cover the patient and protect them from cold and transfer safely without unnecessary movement

All attempts should be made to quickly transfer patient to an appropriate facility with prior intimation to the medical center. It would also be helpful to have nearby emergency aid numbers handy.

Reference: https://www.healthcareindiatoday.com/advanced-trauma-life-support-how-can-lay-people-save-lives-of-accident-victims/

By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund

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